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Friday September 28 is World Rabies Day, focusing on the global problem caused by this horrific disease and how it can be eradicated. Worldwide, some 55000 people still die every year from rabies, most of them children in Asia and Africa.

With the increasing trend for long-haul travel, it’s an issue which is certainly relevant to the UK. In May this year, a woman of Indian origin, in her 50s, died of rabies at the Hospital for Tropical Diseases, after being bitten by a dog while visiting India. The previous February, in Amsterdam, a puppy was found to have rabies after being imported into the Netherlands from Morocco via Spain, the result of lax border controls.

Is there a risk of rabies being reintroduced into Britain, which has been free of the disease since the early 20th century? Recent moves to harmonise EU controls on the cross border movement of pet animals have resulted in a significant relaxation on the rules for importing pets from Europe – so that the UK’s previous six month quarantine period has been confined to history. While in depth risk assessments carried out by bodies such as the Department of the Environment (Defra) have found the risk of rabies being brought in to be extremely low, some would argue that the barrier to rabies entering the UK has been lowered. Illegal imports present the highest risk.

The virus that causes rabies (the Lyssa virus) is good at “hiding” from the immune system, which means the body finds it hard to combat. It multiplies in the brain and salivary glands of an infected dog or other animal, causing it to become fiercely aggressive – the classic “mad dog”. A bite (or even a lick on a scratch or graze) from a rabid dog introduces saliva, teeming with infectious viral particles, into the body of the victim. The rabies virus enters the nerves, tracking up through the nervous system towards the skull, where it invades the brain.

The disease has a long incubation period: it can take many months (up to a year in some cases) for the virus to reach the brain. In humans, early symptoms include fever, vomiting and loss of appetite, as well as excess salivation and weeping; in later phases, there may be paralysis, psychiatric symptoms, and fear of water (hydrophobia). Once visible symptoms appear, death is almost always inevitable.

Pre-travel rabies vaccination, involving three injections over the course of a month, is recommended for anyone planning to be in contact with animals in areas where rabies is prevalent (as well as certain other groups). While the vaccine is not recommended to all travellers to rabies prevalent areas, they should be aware of the need for urgent action if they are bitten (or even licked) by a stray dog. An injection of rabies immunoglobulin which helps neutralise the virus and a course of the rabies vaccine, can be highly effective at preventing the development of the disease after a bite.

Rabies: the facts

Rabies occurs in over 150 countries and territories around the world

Over 95% of human deaths occur in Asia and Africa

Dogs are the source of 99% of human rabies deaths. (The disease is also found in foxes, cats and monkeys)

When travelling overseas, check the rabies status of your destination before you go

If travelling to a rabies-affected area, vaccination is only needed if you expect to be in contact with animalsif you are not vaccinated, thorough cleaning of wounds and obtaining post-exposure rabies immunisation is essential if bitten, licked or scratched by an animal